What is a Panic Attack?
If you have ever experienced an intense fear along with body sensations that are associated with the fight or flight response, such as trembling, sweating and shortness of breath, you may have been suffering from a panic attack.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) divides panic attacks into two categories:
- Expected Panic Attacks: This type is less common and refers to a panic attack associated to a cause (due to a fear). An example of an expected panic attack is one that occurs right before a presentation because of “stage fright”.
- Unexpected Panic Attacks: This is the most common form. Technically, this type does not have a trigger and appears spontaneously.
Panic attacks are associated with panic disorder. According to the DSM-5, in order to diagnose panic disorder, there must be presence of consecutive panic attacks and uncontrollable fear of future attacks. It is associated with agoraphobia, which refers to intense fear of situations from which it is difficult to escape. Panic disorder is one of the most common anxiety disorders, especially in females, and 2% of the general population is diagnosed with it.
How to Identify a Panic Attack
Panic attacks are harmless and brief, typically lasting a few minutes. However, you may suffer from several panic attacks in a row, making the attack feel much longer. Panic attacks require a lot of energy and you may be exhausted after an attack. The symptoms that you experience are similar to when you are faced with a real physical threat, although there is no real danger during a panic attack.
Panic attack symptoms may include:
- Fast, pounding, heartbeat (tachycardia)
- Chest pain
- Shortness of breath (dyspnea)
- Excessive sweating (diaphoresis)
- Faintness, vertigo
- Prickling, burning skin (paresthesia)
- Chills or hot flashes
- Stomach pain
Additionally, you may feel a loss of control, experience a sudden fear of dying, feel like you are going crazy and you may feel detached from yourself or your surroundings.
Diagnosis of Panic Attack
Diagnosis of a panic attack is usually made by your general physician or a mental health professional. They will take a detailed history of your symptoms and perform a thorough physical examination, as symptoms of a panic attack need to be distinguished from those of other diseases.
Additional testing, including blood work, may be used to rule out conditions that may be causing your symptoms, such as hyperthyroidism.
Mitigating the Symptoms of Panic Attacks
Symptoms of a panic attack can be overwhelming, however, the best way to manage your panic attacks is to learn useful strategies to control them, including:
Learning to relax
This strategy makes you focus on just one sensation: breathing. It will help you control other corporal sensations, but it does not stop a panic attack. This involves breathing slowly through the nose and taking deep inhalations that last at least four to five seconds and exhaling similarly (four to five seconds). You must concentrate on the breath to do it consciously. It is not done because a panic attack is harmful; it is used to manage the uncomfortable symptoms associated with a panic attack.
This technique involves closing your eyes and thinking about the parts of your body, from your feet to your head, to relax each section and stop stimulating those muscles. During body relaxation, you should feel the tension of each part of your body being consciously released.
This tool involves identifying thoughts that can trigger physical sensations of panic. What are you afraid of? If you are able to answer this, write it down. For example, "I'll embarrass myself if I ...", "I won't be able to speak", "I will die if I can't breathe.”
Face Your Fears
If you are able to identify your fears, you should repeatedly face them. Overtime, if you repeatedly feel the physical sensations without getting hurt, you will realize there is no real danger to fear and the physical sensations that you feel will no longer trigger a panic attack.
Treatment for a Panic Attack
Selective serotonin reuptake inhibitors are the drug class of choice for the treatment of panic attacks. However, if there is no improvement after a 12 week course, tricyclic antidepressants such as imipramine or clomipramine may be considered. If panic attacks persist and the symptoms are disabling, benzodiazepines may be used for a short period of time to get symptoms under control.
Panic attacks can cause intense fear and leave you feeling exhausted. Learning strategies to control your symptoms can help you get your panic attacks under control. However, in some cases, when panic attacks are part of a larger issue and panic disorder is diagnosed, treatment using selective serotonin reuptake inhibitors, tricyclic antidepressants and possibly benzodiazepines, may be necessary to help control your panic attacks. It is important to discuss your symptoms with your doctor to get an accurate diagnosis and receive appropriate treatment so that your panic attacks do not control your life.